Delhi

North East

CC/322/2022

SMT. MAYA SINGH - Complainant(s)

Versus

HDFC Ergo General Insurance Co. Ltd. - Opp.Party(s)

12 Jun 2024

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION: NORTH-EAST

GOVT. OF NCT OF DELHI

D.C. OFFICE COMPLEX, BUNKAR VIHAR, NAND NAGRI, DELHI-93

Complaint Case No. 322/22

 

In the matter of:

 

 

		Mrs. Maya Singh W/o Late Sh. Pratap Singh, R/o A 8/274, Gali No. 8, Amar Colony, East Gokalpuri, Delhi 94		Complainant
		Versus
		HDFC Ergo General Insurance Co. Ltd., 6th Floor Leela Business Park, Andheri Kurla Road, Andheri (E), Mumbai 400020		Opposite Party
			DATE OF INSTITUTION: JUDGMENT RESERVED ON:                   DATE OF ORDER:		01.08.2022 30.04.2024 12.06.2024

 

CORAM:

Surinder Kumar Sharma, President

Anil Kumar Bamba, Member

 

ORDER

 

Surinder Kumar Sharma, President

The Complainant filed the present complaint under Section 35 of the Consumer Protection Act, 2019.

Case of the Complainant

1. The case of the Complainant as revealed from the record is that the local agents of the Opposite Party visited the residence of the Complainant and the late husband of the Complainant was allured by the agents of the Opposite Party in the presence of the Complainant to take the life insurance cover. The late husband of the Complainant had agreed for the same and Opposite Party had issued a policy bearing no. 2950200515298800000 for a sum insured of   Rs. 5,00,000/- with critical illness of Rs. 1,00,000/- in the year 2013. Complainant stated that her late husband had paid a consideration amount of Rs. 4,379/- against the policy and Opposite Party had issued a document covering the risk on life of Shri Pratap Singh i.e. husband of the Complainant and a duly completed proposal form was also obtained by the Opposite Party. Complainant stated that her late husband had paid the due premium of the policy till 2013 when her husband had expired due to some illness. On 30.11.2013 the death claim was reported to the Opposite Party by way of letter whereby Opposite Party was requested to settle and pay the death claim as per policy. Complainant stated that she sent number of requests to the Opposite Party and also visited the office of Opposite Party and Opposite Party number of times assured the Complainant that payment of the policy would be released in her name being the nominee but the claim was not settled and paid till date. A legal notice dated 12.03.2022 was sent to the Opposite Party but it did not give any response. Hence, this shows the deficiency of service on the part of Opposite Party. Complainant has prayed for Rs. 6,00,000/- being the sum insured of the policy along with 24 % interest from the date of death. Complainant also prayed for an amount of Rs. 1,00,000/- as compensation and Rs. 1,00,000/- as litigation expenses 

Case of the Opposite Party

2. The Opposite Party contested the case and filed its written statement. It is stated that the complaint is not maintainable as the Complainant never lodged/registered any claim with the Opposite Party. It is stated that without registration of any claim the Complainant cannot claim compensation and therefore, there is no deficiency of service on the part of the Opposite Party. It is stated that no claim was lodged by the Complainant regarding the theft of the vehicle. It is stated that the complaint is time barred as the Complainant herself has stated that the complaint was being filed after 09 years of the cause of action. It is stated that the deceased has taken Sarv Surakha Policy vide no. 295020051515298800000. This was the policy regarding the four wheeler loan protection and it was subject to the terms and conditions of the policy. The allegations of the Complainant have been denied. It is prayed that the complaint may be dismissed.  

Rejoinder to the written statement of Opposite Party

3. The Complainant filed rejoinder to the written statement of Opposite Party, wherein the Complainant has denied the pleas raised by the Opposite Party and has reiterated the assertions made in the complaint.

 

Evidence of the Complainant

4. The Complainant in support of her complaint filed her evidence by way of affidavit, wherein she has supported the averments made in the complaint.

Evidence of the Opposite Party

5. In order to prove its case, Opposite Party has filed affidavit of Shweta Pokhriyal, Manager of Opposite Party, wherein the averments made in the written statement of Opposite Party have been supported.

Arguments & Conclusion

6. We have heard the Ld. Counsels for the Complainant and Opposite Party. We have also perused the file and the written arguments filed by the Complainant and Opposite Party. The case of the Complainant is that her husband has purchased a life insurance cover vide policy no. 2950200515298800000. The said policy was purchased in the year 2013. Her husband expired on 04.09.2013. As per the case of the Complainant, death claim was reported to the Opposite Party on 30.11.2013. Thereafter, she sent several requests to the Opposite Party to settle the claim but the Opposite Party did not settle the claim. On the other hand, the case of the Opposite Party is that the Complainant never lodged any claim with the Opposite Party and therefore the complaint is not maintainable. Its case is that the complaint is time barred. The case of the Opposite Party is that the said policy was issued for protection of four wheeler loan and it also covered the followings:

1. Loss of Job (3 EMI)
2. Accidental Death
3. Permanent Total Disability/Permanent Partial Disability
4. Accidental Hospitalization
5. Critical Illness
6. Credit Shield Insurance
7. Garage Cash
8. Householders Coverage

 

7.  Now, the question is that whether the Complainant lodged any claim with the Opposite Party. In her complaint, she has stated that she lodged the claim on 30.11.2013 but there is no such document to show that any claim was lodged. In the index of list of document filed by the Complainant, it is sated that copy of letter dated 03.11.2013 along with death certificate is at page 7. The perusal of the page 7 shows that it is only copy of the death certificate of the husband of the Complainant. No copy of the letter has been attached with the death certificate.  The Complainant has also not produced any postal receipt or proof of delivery of the alleged letter to the Opposite Party. In her complaint, the Complainant has stated that the report was lodged on 30.11.2023, whereas, in the index of the list of document filed by the Complainant shows that the alleged letter was dated 03.11.2023. This is a material contradiction. Therefore, under these circumstances, the assertion of the Complainant that she lodged any report with the Opposite Party cannot be believed.
8. It is also stated by the Complainant that she sent several requests to the Opposite Party office and visited their office number of times. However, the Complainant did not file any proof that she sent any request to the Opposite Party. Nor she has given any date of such request, nor any copy of the letter or proof of delivery has been filed. Therefore this assertion cannot be believed.
9. The husband of the Complainant died on 04.09.2013 but she has filed the complaint on 01.08.2022 i.e. after about 09 years. There is no explanation as to why the complaint was filed after such a long delay. The Complainant has tried to cover the limitation by issuing a legal notice dated 12.03.2022 to the Opposite Party. The issuance of legal notice cannot extend the limitation.
10. The case of the Complainant is that her husband had purchased a life insurance cover vide policy no. 2950200515298800000. On the other hand, the case of the Opposite Party is that the said policy was insurance covering four wheeler loan from HDFC Bank. The said insurance also provided the followings:

1. Loss of Job (3 EMI)
2. Accidental Death
3. Permanent Total Disability/Permanent Partial Disability
4. Accidental Hospitalization
5. Critical Illness
6. Credit Shield Insurance
7. Garage Cash
8. Householders Coverage

 

9. As per the case of Complainant, her husband has died due to some illness. It is not her case that it was accidental death or death due to critical illness. Therefore, the death of the husband of the Complainant is not covered under the above mentioned items.
10. In view of the above discussion, we do not see any merit in the complaint and the same is dismissed.
11. Order announced on 12.06.2024.

Copy of this order be given to the parties free of cost.

File be consigned to Record Room.

 

(Anil Kumar Bamba)           Member

(Surinder Kumar Sharma)            President